PREDICTORS AND IMPACT OF ACUTE KIDNEY INJURY AMONG HOSPITALIZED COVID-19 PATIENTS. Ifeoluwa Stowe MD1, Ayobami Olafimihan MD2, Chukwunonso Ezeani MD1, Damilola Ologbe MD3, Damodar Kumbala MD4; Department of Medicine, Baton Rouge General Medical Center1, Baton Rouge, LA; Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago2, IL; William Harvey Hospital3, Willesborough, Ashford, Kent, England; Renal Associates of Baton Rouge4, Baton Rouge, LA.
Introduction: In December 2019, the first case of the corona virus disease 2019 (COVID-19) was diagnosed in China and it has since then rapidly spread worldwide. Many studies have reported that acute kidney injury (AKI) and other kidney abnormalities like proteinuria and hematuria are common among patients with COVID-19. The incidence of AKI varied from 0.5% to 46% depending on the region and population studied; and the presence of AKI was associated with worse outcomes. We therefore investigated the predictors and impact of AKI among hospitalized COVID-19 patients in the United States (US). Study: Retrospective cohort analyses were conducted using the National Inpatient Sample (NIS), 2020. Multivariate logistic regression was used to identify predictors of COVID-19 related AKI and examine the impact of AKI on in-hospital outcomes among patients with COVID-19. There was a total of 1,018,915 admissions for COVID-19. 25.5% of these were diagnosed with AKI. Amidst COVID-19 patients, there were significant disparities in the predictors of AKI; black race was associated
with 70% more likelihood of developing AKI, compared to whites (adjusted odds ratio (AOR): 1.71, 95% confidence interval (CI): 1.64 – 1.78, p <0.001), and female gender were 30% less likely to have AKI (AOR: 0.69, 95% CI: 0.67 – 0.71, p <0.001). Discussion: Patients admitted for COVID-19 with concomitant AKI had three-fold increased risk of inpatient mortality compared to those without AKI (AOR: 2.89, 95% CI: 2.76-3.03, p <0.001). COVID-19 patients with AKI were thrice more likely to have longer mean length of hospital stay (LOS) (10.5 vs. 6.5 days, AOR: 3.04, 95% CI: 2.88-3.21, p < 0.001) in comparison to their counterparts. Also, COVID-19 patients with co-morbid AKI had 50% higher mean total hospital charges by over $67,084 ($129,136 vs $62,052, 95% CI: 50,760-57,887, p < 0.001) when compared to their counterparts without AKI. AKI was common in hospitalized COVID-19 patients and was associated with significantly higher inpatient mortality, longer LOS, and higher total hospital charges. The significant independent predictors of COVID-19 related AKI included black race and male gender.
A CURIOUS CONSTELLATION OF NEUROLOGICAL SIGNS Raja Saravanan MD, Sriveni Tangellapelli MD, Sneha Puvvada MD, Oana Petcu MD; Department of Medicine, Baton Rouge General Medical Center, Baton Rouge, LA.
Introduction: Atypical presentations of Guillain- Barré syndrome (GBS) have become increasingly common. Facial weakness can be a part of the GBS variants like Miller-Fisher syndrome, pharyngeal- cervical-brachial weakness, polyneuritis cranialis, or bifacial weakness with paresthesia. Case: A 44-year-old female with a history of chemotherapy-induced neuropathy complained of a tingling sensation of her fingers/toes and excruciating lower back pain. She denied bladder or bowel
palsy. Computed Tomography of the head and thoracolumbar spine showed no acute intracranial or spinal abnormalities with an old mild anterior wedge compression fracture of T9. Magnetic Resonance Imaging of the brain, cervical, and lumbar spine showed minimal degenerative changes. She had a lumbar puncture with cerebrospinal fluid (CSF) studies showing slightly elevated protein (50.3) and glucose (84) with 0 WBCs. She was discharged home on oral prednisone and valacyclovir for Bell's palsy.
dysfunction, perineal numbness, muscle weakness, and prodromal respiratory or gastrointestinal illness. She had a Tdap vaccination about one month before the presentation. Neurological examination was unremarkable except for left-sided facial nerve
One week later, she re-presented with difficulty walking, bilateral lower extremity weakness, and urinary retention. Examination showed elevated blood pressure, 3/5 power in bilateral lower extremities with absent deep tendon reflexes 40
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